How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Ed Wilfong Your Own Question

Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
25396616
Type Your Mental Health Question Here...
Dr. Ed Wilfong is online now
A new question is answered every 9 seconds

Im weening off sertraline to start celexa. I went from 200mg

Resolved Question:

I'm weening off sertraline to start celexa. I went from 200mg of sertraline and for the past week have only been taking 100mg. I am also taking .5mg of clonazepam almost every day and then at least one vicadin a day for tooth pain. I hate pills! I just want to be taking one antidepressant and not feel dizzy head, anxiety, and depression. Whats the formula I need to stick with?
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 4 years ago.
First of all, the anti-depressants you are on are Zoloft and Celexa. The plan in place to taper down the Zoloft and stay on Celexa. Correct? You should ultimately only be on one. It sometimes takes some trial and patience to find the right one. Tapering the Zoloft should only take about 2 weeks.

The Vicodin as a Narcotic pain reliever. While you are using it, it can have unpredictable effects on how well antidepressant works (not dangerous, just can prevent it from working. I assume that and the Motrin are for temporary use for the tooth pain. Using motrin for migraine headaches every day can actually make the headaches worse and lead to rebound headaches. The chemicals influenced by anti-depressants is also the one addressed by the newer anti-migraine medications, such as immitrex. It cannot be taken with the antidepressants. An alternative you can use when you feel a migraine coming on is MAXALT. You put it under tongue, it dissolves and often prevents migraines. It is much more effective to be able to anticipate a migraine and prevent it than stop it after it starts. Ask your MD.

The Klonapin is a benzodiazpine and is a low dose of a minor anti-anxiety medication. It is for short term use as you will eventually need more for same effect, which is not a good cycle to get into. Often it is used only until the antidepressant starts to work.

I would hope the goal IS to to have you only on Celexa. It may be hard to tell which is working best while on Vicodin. Perhaps then, just having an as needed medication, like maxalt, for migraines will not be too many drugs.

If there is a "reason" for your depression - something bad happened or perhaps abuse in childhood, counseling will be a helpful part of treatment. Research indicates that counseling plus medication is superior to either alone, yet both can work alone, often equally well.

Edited by Dr. Ed Wilfong on 12/3/2009 at 1:06 AM EST
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience: Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
Dr. Ed Wilfong and 2 other Mental Health Specialists are ready to help you
Customer: replied 4 years ago.
I really appreciate your answer. I didn't taper off zoloft for two weeks. I tapered down from 200 mg to 100 in 8 days. Then today instead of taking 100 mg of zoloft, I took the 20mg of celexa. The sertaline quit working three months ago. So my depression and anxiety has stemmed primarily from that. I hope I haven't made a mistake by taking the celexa before tapering for two weeks. Both my primary and psychiatrist were out of the office today. I just want to feel better. I feel really good tonight. I hate that it has taken so many pills to make me feel this way. So. If I'm okay starting the celexa now, I take the celexa for the depression, MAXALT (otc?) for oncoming migraine but then what for the tooth pain? I have my root canal scheduled for two weeks from now. *first available.
Expert:  Dr. Ed Wilfong replied 4 years ago.
You should be OK on just 20mg of Celexa. If you start feeling really crappy, you may need a little more time with zoloft. Sometimes I have seen MDs half the dose of each, e.g. 50 zoloft, 10mg Celexa for 4-5 days then quit zoloft and increase celexa. Combining SSRIs can be dangerous due to a very small possibility of Serotonin Syndrome. You doses would be low enough to be ok, but don't increase Celexa to 20mg before d/c zoloft. You can really quit zoloft as quickly as your body tolerates it. The taper is for your "comfort" more than anything.
The Vicodin is fine until you get teeth fixed. Just not good long term.
Maxalt is by prescription only. I hope you have good insurance. Not cheap.
Just keep on Celexa 20 unless you start feeling crappy. Your plan is actually pretty good as you will have some SSRI in system while starting Celexa and they are similar enough that you are not "starting over"

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education